Losing the Individual Mandate may mean absolutely nothing? (VIDEO) #TheLastWord

Maybe.

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Signs you've been in the Senate too long (a not-too-fond farewell to Orrin Hatch)

Courtesy Ezra.

It's not like I ever liked Hatch to begin with, but he is an arrogant bastard. And while it's very likely we wind up with someone like Mike Lee as his replacement, let it be said, Hatch is going down in 2012, and I won't shed any tears:

Perhaps the most telling moment came when Utah's Orrin Hatch scolded Charles Fried, a Harvard law professor who served as Ronald Reagan's solicitor general and considers the mandate easily constitutional, for the quality of his arguments.

The primary flaw Hatch pointed out in Fried's thinking was that, well, Hatch disagreed with it. Despite his preexisting respect for the quality of Fried's legal thinking, the fact that Fried's position differed from Hatch's had left Hatch "shocked" at Fried, not more skeptical of his own thinking. Motivated skepticism in action, I guess.

Why we need an individual Mandate in Health Care Reform

NC Steve is a user at Talking Points Memo, he happens to be a Lawyer originally from Kentucky. He's a clear-eyed Obama Democrat, and is able to cut through a lot of the legal B.S. that's floating around out there. It used to be possible to follow his responses in TPM until they changed their constantly-broken commenting system.

Anyway, I saw him crop back up in a discussion of Health Care, and he wrote one of the best, simplest explanation for the Individual Mandate that I've ever read.

So this is the work of NC Steve 3.0 on TPM (real name unknown). Hat's off to you, Steve!

Insurance only works if the amount of income from premiums at least equals benifits+admin and overhead cost+(if the insurer isn't a non-profit) profits ("payout"). If payout exceeds income, the insurer collapses into bankruptcy and everyone is screwed.

In a group plan, income and payout are balanced because participation is not voluntary--good risks and bad risks alike will be in the plan, paying premiums, or having them paid for them by their employer. (I cannot opt out of my firm's plan and ask them to give me the money they give BSBC of NC. If I "opt out," the boses simply puts my premium in their own pockets, so of course, I participate).

In the individual market, however, participation is entirely voluntary and the money is actually coming out of the insured's own pocket. This means that sick people want insurance and healthy people, especially the young ones who think they're invulnerable and immortal, don't. In that market, insurers keep income and payout balanced by trying to avoid insuring people who are statistically more likely to need benefits (people with preexisting conditions) and by trying to revoke the policies of people who make claims on the grounds that they lied to them about what a terrible risk they were.

The law forbids insurers to deny or revoke. That means they will, by defintion, be insuring people who will increase the payout. Without a mandate, healthy people can just sit it out unless and until they are injured and sick, at which point they sign up, which means there will be no corresponding increase in income.

The point of the mandate is to make the economics of the individual market work the same way the economics of a group plan work. Without it, non-group plans collapse and everyone is screwed.

Remember what I said about Tim Pawlenty?

Never mind:

Although Minnesota Gov. Tim Pawlenty (R) on Tuesday signed an executive order aimed at keeping the Patient Protection and Affordable Health Care Act out of the state, he has also approved a budget that encourages state agencies to apply for grants funded by that very same health care law.

Pawlenty's executive order explicitly states, "All executive branch departments and agencies are directed that no application shall be submitted to the federal government in connection with requests for grant funding for programs and demonstration projects deriving from the Patient Protection and Affordable Care Act ("PPACA" or "the Act") (Pub.L. 111-148) unless otherwise required by law, or approved by the office of the Governor."

But in Minnesota's Special Session Budget, signed by Pawlenty on May 21, the state health commissioner is directed to apply for grants from this exact law:

Do as I say, not as I said to get a couple of headlines a couple days ago in the interests of my faltering Presidential ambitions.

And yes, I know I just ripped Huffington Post and quoted something from Huffington Post in the space of two postings. I am just Mr. Consistency!

The Republican Con-job on Health Care

As expected a number of states are suing the Federal Government over the “Individual Mandate” in the Affordable Care Act (aka Health Care Reform), all while they work very hard to collect the money they're suing to...keep from...having to take??

Anybody get all that?

The Conservative position is simple. The Individual Mandate makes people buy Health Insurance, and people shouldn’t have to be forced to buy Health Insurance if they don’t want to.

Here’s the problem with that notion. One of the most popular aspects of Health Care Reform is the provision that forbids Insurance Companies denying you coverage based on Pre-Existing Conditions. This provision is so popular that even Conservobots who voted against the bill say that this is the one thing they agreed with. If the Democrats had just gotten rid of the Individual Mandate, we could have voted for Health Care Reform.

Of course, that’s bull@#$%. One of the hard lessons people learned in the last few years is you cannot have one without the other.


Paul Krugman from back in March:

So what’s the answer? Americans overwhelmingly favor guaranteeing coverage to those with pre-existing conditions — but you can’t do that without pursuing broad-based reform. To make insurance affordable, you have to keep currently healthy people in the risk pool, which means requiring that everyone or almost everyone buy coverage. You can’t do that without financial aid to lower-income Americans so that they can pay the premiums. So you end up with a tripartite policy: elimination of medical discrimination, mandated coverage, and premium subsidies.


Or to put it another way, you end up with something like the health care plan Mitt Romney introduced in Massachusetts in 2006, and the very similar plan the House either will or won’t pass in the next few days. Comprehensive reform is the only way forward.

Of course, as you remember, the reform was passed, and Republicans are campaigning to repeal it.

It’s very simple. Health Care is a complicated machine. Piecemeal reform isn't going to cut it (as Dr. Krugman said). If you wanna do X, then you have to do Y. If you don’t, costs spiral out of control and soon nobody will have Health Insurance (see, Insurance Death Spiral).

Which brings me to Tim Pawlenty, Governor of Minnesota, and potential Republican Candidate for President in 2012, doing his damnest to make it impossible to carry his own state.


From Steve Benen:

As implementation of the Affordable Care Act proceeds, the law extends subsidies to states to help early retirees -- folks who leave the workforce before they're eligible for Medicare, but who still want to maintain their coverage. States led by Republicans may claim to hate the new law, but they're nevertheless seeking the funds -- even many of the states trying to kill the ACA in court.

In Minnesota, Gov. Tim Pawlenty (R) is taking a different route. The increasingly right-wing governor, desperate to pander to the party's base in advance of his presidential campaign, issued an order to state officials yesterday, demanding that they not seek grants through the new law, even if the funding would help the people of his state.

Keep in mind, this isn't some kind of opt-out scheme -- the law still applies to Minnesota, just like every other state. This is a scheme whereby funds are made available to states, and Pawlenty is demanding that Minnesota not seek those resources, at least for now.

Let’s call it what it is. Tim Pawlenty is screwing over the uninsured in his state to burnish his Conservative Credintials in advance of the 2012 race.

What a guy!

Needless to say Doctors in Minnesota are pissed off:

The heads of Minnesota's most influential medical associations -- which nearly always keep political matters at arms' length -- issued a sharp rebuke. "The governor's decision just doesn't make sense for Minnesotans," the Minnesota Council of Health Plans, the Minnesota Hospital Association and the Minnesota Medical Association said in a joint statement late Tuesday.

But not all Doctors are pissed off, according to Jonathan Chait. Actually, they are pissed off, but for them, not for you:

Hal Scherz, a doctor and president of the right-wing lobby "Docs4PatientCare" writes in today's Wall Street Journal that he and members of his group are posting letters in their waiting rooms warning patients of the horrors of the Affordable Care Act and urging repeal.

This is all real simple.

Republicans don’t give a rats ass about deficits or future costs. Period. All they care about is representing the Corporate Master who has given them a lot of campaign cash. They don’t care about the Health of the Health Care System. It’s broken (but starting to mend thanks to HCR), a fifth of our Citizens can’t access it, but screw ‘em. They should have been born to richer, whiter households. We don’t like President Obama anyway, and this seems as good an excuse as any to rail against him, even if it means lying through our teeth to get the job done.

If you fall for this, America, you'll fall for anything.

We’re about to learn a lot about America in the coming months. I maintain my position that the problem with the country isn’t its Polticans, but its people.